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Weighing in about Healthy Weight – it’s not about what you can lose, it’s about what you can gain!

by Alex Inman

I had the great opportunity to attend the Provincial Health Services Authority’s Healthy Weights Forum on June 21st when BC healthcare professionals discussed healthy weights and weight bias/stigma. This became particularly relevant as both Canadian and American media have been reporting heavily about two news articles related to weight. First was the recent discovery of a possible link between school healthy eating programs and eating disorders found by Dr. Leora Pinhas in Toronto, ON (CBC article here). The second news-making announcement was the recent classification of obesity as a disease by the American Medical Association (CBC article here).

Even though healthcare professionals have known for years that weight (i.e. the Body Mass Index or BMI) is not the best indicator of health, our society still equates being thin with being healthy. However, it is just as possible for an overweight individual to be healthier than a normal weight individual, as categorized by the BMI. In actuality, someone’s perceived weight tells us very little about their overall physical, mental, and emotional health. These aspects of health cannot be quantified into a number or onto a scale; they are achieved by a holistic approach to health both at home, at work/school, and in healthcare. Therefore, in my opinion, obesity is not a disease because having a BMI over 30 does not guarantee you are ill. In fact, it doesn’t really mean much at all.

Working at DASH has allowed me to learn more about the Comprehensive School Health (CSH) approach, which is a holistic way of looking at healthy schools. Instead of trying to make healthy changes in schools only by educating children, CSH encourages us to look at other aspects that may be affecting the health of the school community. For example, besides the teaching and learning aspect we need to also consider: the social and physical environment, school policies, and the potential for partnerships and services. Through the healthy eating lens, CSH would inquire how we can encourage students to eat healthier through nutrition education, ensuring the school environment and policy promotes healthy eating behaviours, and looking to the community and surrounding organizations for support. By looking at changing eating behaviours of students through CSH, we’re approaching the issue in a holistic way. The pressure, then, is not entirely on students to ‘be the best’ at eating healthy or ‘getting an A in nutrition’ which may trigger disordered eating in a select few students. With CSH, the whole school community is making the shift to living a healthier lifestyle.

Both of these issues are obviously very complicated and inextricably linked to many aspects of our society and other topics in nutrition, weight, and healthy lifestyles. However, we all need to keep in mind that your weight does not define your worth. Healthy weights, in conclusion, should not be about what you can lose, but what you can gain.

We here at DASH would love to hear about what you think about these stories. Did you already know about the shift in BC from ‘battling obesity’ to ‘promoting healthy weights’? How do you think all of us can continue to encourage health (physically and mentally) to British Columbian students? How do you maintain a healthy lifestyle? Leave a comment below!

Comments

  1. Thomas says:

    BMI is quite obviously a poor measure of health as well as obesity, as there is no control for differences in lean mass (muscle and bone). However, is your suggestion that other measures which do account for this (such as body density) is a similarily poor indicator?

    Reply
    • Hi Thomas,

      Great point! Yes, there are other measurements we can use to determine a person’s fat vs. fat-free mass, for example, underwater weighing. However, none of these measures are as easy or as FREE as BMI so it would be hard for every healthcare professional to use them to weigh their patients – they’re not really a solution to this issue.

      Weight, measured by any standard, is a poor indicator of health. One of the things that stuck out in my mind from the Healthy Weights Forum I attended was when a GP was telling us about two patients he had currently. One of his patients who had a BMI of 60, was completely metabolically healthy and only had some mobility issues. Another patient, with a BMI of 30, was metabolically unhealthy with all sorts of medical complications such as Type II DIabetes. What we’ve found, in practice and in evidence, is that while obesity may statistically increase risk for certain diseases and conditions, it by no means tells us anything. In essence, we couldn’t calculate someone’s fat mass and say “For sure this person has medical complications, like diabetes” – we have to look deeper to see if there are any health issues.

      I think the real point I’m trying to get at here is that no scale or measurement can tell you if someone has positive mental health, eats well, is physically active, and is resilient when it comes to stress/anxiety. Our society has embedded weight bias into our culture and beliefs so that some of us may find it hard to believe that someone who is classified as overweight eats better and exercises more than someone who is classified as normal weight… and we haven’t even started to look at mental health indicators.

      Our value, as a society and as healthcare practitioners, should be on helping everyone to be at their healthiest. Regardless of shape or size, the ideal is for our entire society to lead a lifestyle where they eat healthy, exercise regularly, and have positive mental health. Shouldn’t we focus on that rather than trying to find ways to measure, scale, and further obsess over weight?

      Alex

      Reply

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